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PSA analysis is normal. How to take a blood test for PSA, proper preparation

Prostate cancer occupies an "honorable" third place in terms of mortality among other oncological diseases, and in the group of older men it is the leader. PSA analysis helps to diagnose it in a timely manner and take timely measures. What is it and how to prepare for it so that the results are correct?

What does the abbreviation PSA mean?

PSA or PSA is a prostate specific agent. In its structure, it is a protein polypeptide consisting of more than 200 amino acids. Both diseased and healthy cells of the prostate produce this substance, so every PSA test shows its small presence in the blood. The norm for each age category of males is different, since with age the prostatic specific agent is produced in greater quantities. In healthy men, it is present, in addition to blood, in the ejaculate (semen) and in the prostate secretion. If there are tumor cells in the prostate gland, the prostate agent begins to be produced in significant volumes, which is used in the unmistakable marking of the disease. In addition to diagnosing the disease, the analysis is performed to monitor the health status of patients who have already been treated or are being treated for cancer or prostate adenoma.

Age norms

Prostate cancer is a very insidious disease. If it is detected at the wrong time and treatment is started late, it inevitably leads to death. As medical statistics show, this type of cancer is not associated with smoking, alcoholism, the intensity of sexual activity and sexually transmitted diseases, that is, every man can get sick with it. The only way to detect this disease in time and thereby save your life is a PSA blood test. The norm can be temporarily exceeded, which is associated with certain diseases. In such cases, the analysis is repeated or additional studies are carried out.

What is a gray area?

For research, blood is taken from a vein. The results of the analysis, when the values of the prostatic agent are above the norm, but do not exceed 10 ng/ml, are called the "gray zone". In such cases, the doctor may order a prostate biopsy. The main indication for its implementation is the ratio of the so-called free PSA to the total. It in healthy men should be above 15%. The fact is that only about 10 percent of all forms of the prostatic agent are present in this state. The remaining 90 percent is associated with either a-1-antichymotrypsin (a protease inhibitor) or a-2-macroglobulin (an inhibitor of pepsin, plasmin, and other enzymes). Being in combination with a-2-macroglobulin, PSA is practically not determined. Laboratory studies show only the amount of free and associated with a-1-antichymotrypsin of the prostatic agent. Their total value is demonstrated by the so-called general PSA blood test. If a man has Prostate cancer, a-1-antichymotrypsin begins to be produced in large quantities in the body, which leads to greater binding of the agent and a decrease in its free form. Consequently, the percentage of these two forms decreases.

What is the reason for exceeding the norm?

Some diseases have a great influence on the quantitative indicator of PSA in blood serum samples. The most dangerous of them is prostate cancer, that is, a malignant enlargement of the prostate that is not associated with age and gives metastases. At the slightest suspicion of cancer, manifested in painful urination, sensations as if the bladder is not completely emptied, frequent urge and difficulty urinating, and pain in the perineum, a PSA test should be done. The norm is typical for healthy people, while an increased level can be with the following diseases:

Adenoma (a benign tumor that does not metastasize);

Heart attack (necrosis due to spasm);

Ischemia (anemia of the prostate associated with problems in the blood vessels);

Acute renal failure.

What factors cause an increase in the prostatic agent?

Several factors influence the amount of prostatic agent in the blood. Therefore, in order to obtain a reliable PSA analysis, preparation for it must be carried out very seriously. The excess is affected by:

Deep prostate massage;

TRUS (specific ultrasound of the prostate gland);

TURP (surgical effect on the prostate).

Factors that do not affect the readings:

Insertion of a catheter into the bladder and cystoscopy;

Rectal (with fingers) examination of the prostate.

Preparing for analysis

It is the responsibility of every patient to know and strictly follow the preparation requirements before doing a PSA test. Its norm for different ages is well known. The level can be increased not because of the pathology of the prostate, but because of non-compliance with special conditions.They are as follows:

Abstinence from ejaculation for at least 2 days before analysis;

Carry out the analysis no earlier than 3 days after deep prostate massage;

If the patient is undergoing TRUS, at least 7 days must pass after the procedure before PSA analysis;

After a biopsy of the prostate, which greatly increases the amount of agent in the blood, at least 6 weeks must pass before analysis;

If the patient underwent transurethral resection, PSA analysis is allowed no earlier than 6 months after the operation.

In addition, before the analysis, it is advisable to refrain from smoking, not to eat fatty foods for more than a day, to avoid excessive physical and mental stress.

When is an analysis scheduled?

If prostate diseases are suspected and during the treatment of detected tumors, a PSA analysis is prescribed. The norm in those on treatment depends on the type of therapy. So, after surgical removal of the prostate (laparoscopic prostatectomy), the digital indicator of the prostate-specific agent, as a rule, decreases to 0.2 ng/ml, and after radiation therapy to 1 ng/ml. These indicators are very favorable and allow us to hope for a long period without relapses. If, after all types of therapy, the PSA level increases, we can state the further development of the tumor process. However, an excess of PSA is not always indicative of cancer. In rare cases, the result is influenced by the individual characteristics of the patient's tissue barriers. There are people whose tissues have increased permeability, so the prostatic agent seeps into the blood more easily, and, as a result, its amount is somewhat overestimated.

What measurements are taken to clarify the diagnosis?

As noted above, with age, the prostate gland increases in every man. To reduce the effect of this natural increase on test results, PSA density is measured. This indicator is determined by dividing the quantitative indicator by the measured prostate volume. If the quotient obtained by division is higher than 0.15 ng / ml / cm 3, there is a suspicion of the onset of pathological changes in the prostate gland. In such cases, a biopsy is performed on the person. Another type of study is to determine how fast PSA changes. If the value is higher than 0.75 ng/ml/year, the patient has a very high probability of developing a tumor. The data of the analysis help to determine with sufficient accuracy the presence of metastases in a patient. So, with indications of a prostatic specific agent above 50 ng / ml, there is a high probability of the onset of the metastasis process. And numbers above 100 ng / mg state the presence of deep metastases.

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PSA test: why is this blood test taken and what are its normative values?

Different laboratory tests are used to detect disorders in the functioning of the prostate gland. One of the dangerous and difficult to detect diseases is prostate cancer.

To confirm or refute this disease, a general PSA test, which is performed on a sample from a taken blood sample, allows you to confirm or refute this disease.

The article will tell you what this method is, how often and how it is carried out, and what its results say.

Characteristics of the general PSA test

Many patients are interested in: PSA analysis is general, what is it and what is it for?

A general PSA blood test is a laboratory test that is performed to determine the amount of prostate specific antigen (or PSA for short).

It is a protein that is synthesized in the male organ - the prostate.

If the level of this substance is elevated, this indicates that the prostate is not functioning properly. Moreover, it is not necessarily a cancerous tumor. There may also be a common inflammatory process - prostatitis. In any case, an increase in concentration indicates that the man needs to undergo a thorough examination.

What is it for?

The PSA test and its results are needed by the urologist to determine further steps in the diagnosis or treatment of the patient. At the European Prostate Center, this analysis is included in the list of standard procedures.

PSA test is used for:

Early diagnosis of prostate cancer; early detection of inflammatory processes and prostate adenoma; timely diagnosis of recurrence of malignant tumors of the prostate. In this case, the analysis is performed after surgery; evaluating the effectiveness of the oncology treatment regimen; prevention of malignant and benign prostate diseases.

What conclusions can be drawn from the results?

The male body is designed in such a way that with age, the prostate increases in size. Along with this, the PSA indicator also increases. Therefore, when the urologist studies the analysis, he takes into account what age category the patient belongs to.

Regular values depending on age are given below:

If a man is under 40 years old, the result should normally not exceed 1.4 ng / ml; from 40 to 49 years, the absence of pathology is indicated by a value of 2.5 ng / ml; men 50-59 years old can be calm about their health if the PSA is 3.5 ng / ml; at the age of 60 to 69 years, the standard is 4.5 ng / ml; in the period from 70 to 79 years, PSA in the blood should not exceed 6.5 ng / ml.

As for oncology, many doctors are wary if the PSA value in the blood of a 45-55-year-old man is above 4 ng / ml. But it should be noted that with benign prostate adenoma, the test results also often exceed 4 ng / ml.

When diagnosing oncology, the PSA test is used as a tumor marker. The ratio of free PSA to total is expressed as a percentage. The norm is more than 15%. The lower this percentage, the higher the chances that an elevated total PSA level is caused by cancer. Therefore, if the value is below 10-15%, then the urologist is obliged to refer the patient for ultrasound, MRI, TRUS and biopsy.

After a while, the doctor orders a test again to make sure that the cancerous tumor has not started to grow again. If, during a subsequent study, the PSA level increases, this gives the right to suspect that there are tissues in the body that are affected by cancer.

To make an accurate diagnosis, urologists pay attention not only to the PSA level, but also to other parameters of this test. For example:

The rate at which PSA increases. To do this, a comparison of blood tests made at different times is carried out; the ratio of bound to free PSA.

Deviations from the norm indicate that there is a possibility of cancer. Therefore, the doctor prescribes a number of additional examinations. For example:

If the results of these tests show abnormalities, then the urologist refers the patient for a prostate biopsy.

PSA analysis for prostatitis: norm, features of preparation and recommendations

PSA protein is a prostate-specific antigen produced by the tissues of the prostate gland. This protein is required to liquefy male sperm. It should be noted that malignant neoplasms produce a greater amount of this substance. That is why PSA is used as a tumor marker for prostate cancer. At the same time, any pathological process can affect the amount of protein produced. Therefore, PSA analysis for prostatitis is mandatory. It will allow to identify oncology or adenoma.

Why Protein Levels Increase

To determine the level of protein, a general PSA blood test is taken for prostatitis. The norm of the antigen is no more than 4 ng / ml. The production of this protein increases significantly during the formation of malignant cells. Otherwise, the production of antigen increases due to other factors:

PSA levels can rise as a result of infection, which is accompanied by an inflammatory process. In this case, there is a violation of the barrier functions of tissues, which allows the substance to gradually penetrate into the blood. The protein can enter the blood more actively if the overgrown tissues with benign prostatic hyperplasia begin to put pressure on the rest of the tissues of the organ.

It is worth noting that PSA analysis for prostatitis allows you to identify any deviations and disorders in the functioning of the prostate gland. Most of the men who have an elevated antigen level do not suffer from oncology. The protein concentration may increase as a result of bladder surgery or prostate biopsy, as well as during ejaculation and prolonged exercise.

When analysis is scheduled

Not only with prostatitis, you need to take a PSA test. Such a laboratory study is assigned:

To monitor the progress of prostate cancer. This allows you to check the effectiveness of the chosen therapy. If you suspect the formation of a tumor of the prostate. This can happen as a result of other studies: ultrasound, rectal digital examination, and so on. For prevention. Such an analysis is prescribed for men over 40 years of age to detect an increase in PSA levels. After antitumor treatment, which was carried out after the discovery of prostate cancer. After such therapy, it is recommended to undergo such an examination every 3 months.

Preparing for analysis

To take a PSA test for prostatitis, you need to carefully prepare. Otherwise, the protein level readings will be incorrect. Experts recommend:

For 8 hours before donating blood, refuse to eat, including alcohol, coffee, tea and juice. You should refrain from sexual intercourse 5-7 days before the test. The analysis should be taken 12-14 days after the examination by the urologist or before visiting this specialist.If prostate massage, transrectal ultrasound, bladder catheterization or cystoscopy, rectal finger examination or other mechanical effects on the prostate were performed, then the analysis should be taken 2 weeks after such research methods, and after a biopsy of prostate tissue - after 1 month.

The study is carried out in a laboratory within one day. For this, the patient needs to write out a referral from the attending physician, prepare, and then donate blood from a vein. In some cases, either total PSA or free antigen is required. This is required for an accurate diagnosis.

How to understand the results

PSA analysis for prostatitis can be interpreted in several ways. Antigen levels are usually measured in nanograms per milliliter of blood. However, some experts argue that it is necessary to lower the minimum threshold to 2.5 ng / mg. This will of course allow more prostate diseases to be detected. However, there is a risk that doctors as a result of such a test will begin to treat cancer that is clinically irrelevant. When diagnosing, only three forms of protein are taken into account:

It is found in the blood and makes up only 20% of the total PSA level. A protein associated with a2-macroglobulin or a1-antichymotrypsin. Only the latter type of antigen can be determined in the laboratory. The total PSA indicator is the totality of the protein that enters the bloodstream.

What indicates prostatitis

Prostatitis, in fact, is not a malignant disease. After all, it does not even increase the likelihood of developing cancer of the gland. However, regular monitoring of the PSA level allows the specialist to correctly adjust the therapy aimed at eliminating the inflammatory process.

If the concentration of the antigen is from 4 to 10 ng / ml, then this may indicate the development of the following ailments:

Prostatitis; benign prostatic hyperplasia; prostate cancer, in this case, the risk of diagnosing this disease increases by 25%.

It is worth noting that experts call such an indicator of the PSA level a gray zone. If the concentration of the antigen increases by more than 10 ng / ml, then the likelihood of developing an oncological process increases by about 67%.

Often, the level of total PSA directly depends on the type of prostate disease. Such an analysis is often used for differential diagnosis.

How disease is defined

If the general PSA blood test for prostatitis is carried out correctly, and the protein level is at least 4 ng / ml and not more than 10 ng / ml, then when making a diagnosis, doctors look at the following protein fractions and their ratios:

Reducing the concentration of free antigen increases the risk of developing cancer. This is due to the fact that malignant cells produce a large amount of a1-atichymotrypsin. This increases the concentration of the protein in the bound form. Increasing the concentration of free antigen, on the contrary, reduces the risk of developing oncology. At the same time, such an indicator may also indicate the presence of chronic prostatitis.

Additional data

A total PSA blood test for prostatitis, the cost of which is specified in the clinic, is recommended to be taken by men over the age of 50 every year. At the same time, to improve the test, specialists introduced additional indicators that allow us to consider the protein in accordance with various parameters.

The analysis takes into account the density of the PSA. This allows calculations of antigen concentration in relation to the size of the gland itself, which are determined by transrectal ultrasound. Low protein density may indicate that the main reason for its growth lies in the development of prostatitis.

The speed of the PSA is also taken into account. This is a comparison of the antigen over certain periods of time. If the indicator increases rapidly, then the doctor can diagnose acute prostatitis or the initial stage of cancer.

Protein levels to be monitored

Only a general PSA blood test for prostatitis allows you to track the level of protein. The specialist should definitely know the features of this test. For example, recent studies have shown that it is prostatitis that can lead to an increase in the serum level of the antigen. You should take the test even in cases where there are no signs of inflammation and a digital rectal examination did not reveal any abnormalities, and the rate of increase in PSA concentration has increased.

Such phenomena primarily indicate that the main organ of the reproductive system does not perform its functions well due to certain disorders. If there are sharp jumps in indicators, then experts recommend:

If the protein level has increased significantly, then it is worth checking for signs of prostatitis, as well as a genitourinary infection. After treatment of prostatitis or genitourinary infection, a PSA test should be taken again.

Even if prostatitis has not been diagnosed, it is still worth doing another antigen test. If the protein level remains elevated, the doctor may order a biopsy. This will either exclude or confirm the development of oncology.

Final

At the same time, in some clinics, the patient must additionally pay for taking blood from a vein. The exact price can be checked in the laboratory.

It is worth noting that there is no direct evidence that prostatitis leads to prostate cancer. Malignant cells are not always formed. However, the histological signs of prostatitis are often detected by specialists in the study of cancerous tissues of the prostate. Therefore, a blood test for the amount of PSA should be carried out regularly.

Preparing for a PSA blood test for men

Urological diseases in men at an early stage are often asymptomatic. Only a blood test for PSA allows you to determine their presence and correctly diagnose. To avoid making a mistake when making a diagnosis, every man needs to know how to properly donate blood for PSA. There are certain rules for preparing for analysis, which are important to follow. This will eliminate the distortion of the results of the study and prescribe the appropriate therapy. How to take an analysis, what should be the preparation for the PSA analysis - later in the article.

The essence of the study

Prostate specific antigen - this is the abbreviation for PSA - a protein produced by the male prostate. It is an essential component of prostatic secretion and seminal fluid. Normally, only a small amount of it is present in the blood of a man, with various pathologies, the content of the prostate antigen in the blood increases. Determination of the PSA level is crucial in establishing and differentiating the diagnosis in diseases of the male genitourinary system.

In the blood, the prostate antigen is detected in free and bound form. Together, these forms make up the overall indicator level. When diagnosing prostate diseases, an analysis is made taking into account the value of free PSA and its ratio to the total level

A PSA test for preventive purposes is recommended for every man who has reached the age of 45. Indications for holding can also be:

• Suspicion of benign enlargement of the prostate (adenoma).
• Differential diagnosis of cancer, prostate adenoma and prostatitis.
• Control of the dynamics of prostate diseases.
• Appearance of bloody discharge in urine or semen.
• Pain in the lower back of unknown etiology.

With the help of this analysis, it is possible to detect prostate cancer at an early stage, when it is possible to completely cure a person of this terrible disease by choosing the right treatment. Therefore, it will not be superfluous to periodically check the concentration of PSA in the blood for those men who have cancer among their close relatives, even if they do not have any symptoms.

An analysis is performed if prostate adenoma is suspected

What can lead to distortion of research results

An increased value of prostate-specific proteins in the blood does not always indicate the presence of pathologies of the genitourinary system, this can happen if proper preparation has not been carried out or the rules for its delivery have not been followed. Several factors can trigger an increase in PSA levels.

The presence of these factors and improper preparation make the results unreliable and can cause unnecessary worries about the health of a man with an increased PSA in the analysis.

Therefore, it is important to know the rules for passing the test in order for the study to show a reliable result. This will allow us to track the growth dynamics of this indicator in the future.

What you need to do for sure

Many men are interested in how to properly take the test in order to avoid false negative or false positive results. You need to start preparing for it in advance. Competent preparation for the delivery of the PSA analysis eliminates the possibility of erroneous determination of the level of this protein in the blood. Getting a PSA test right is not that difficult. For preliminary preparation, the following rules and recommendations are required.

Before taking tests, you must give up bad habits

The test should be done no earlier than two weeks after any impact on the prostate gland (massage, palpation during examination, biopsy, removal of the catheter from the bladder). Two weeks before the test, you should not take drugs that increase testosterone levels and increase potency.

With appropriate preparation for analysis, the normal value of prostate-specific antigen in a healthy man under 40 years of age should be about 2.5 ng / ml. The average PSA level in the blood of men of all ages is considered to be 4 ng/ml.

Prostate antigen test steps

The following questions are of interest to most men: how and where can I take a PSA test, in how many days will it be ready? After proper preparation, you can take a blood test for PSA in the treatment room of any multidisciplinary clinic or at paid sampling points. Determination of PSA in the blood can be carried out from venous blood. A sufficient amount for research is 2 ml, but 5 ml is usually taken. To make an analysis according to all the rules, you need to go through certain stages.

The result is ready the very next day. You can do a PSA test in combination with other studies aimed at identifying and differentiating prostate diseases. To diagnose cancer, the test is done not once, but several times during the year. When monitoring the course of the disease, the analysis is repeated regularly every year (once a quarter).

As a rule, only donating blood for analysis is not enough for a complete diagnosis of the disease. If prostate cancer is suspected, a man is usually given a biopsy and transrectal ultrasound, and additional examinations are prescribed.

Now we know how to take a blood test for PSA and what to do before preparing for it. It is very important to follow all the rules of preparation before taking the test in order to get a reliable result and start treatment on time if any pathology of the prostate is detected. Properly prescribed therapy at an early stage of the disease makes it possible for the patient to fully recover even in the case of a positive cancer test result. A neglected disease is much more difficult to treat and the prognosis is often unfavorable.